Flashcards in Seronegative AI Inflam arthropathies Deck (21):
Where does ankylosing spondylitis affect?
Spine and sacro-iliac joints
What eventually happens in ank spondylitis?
Fusion of intervertebrla joints ("bamboo spine") and SI joints
Are females more affected in ank spon?
No males are 3:1
What do pateints with ank spon present with?
Pain and stiffness in back and SI joint
extra-articular features - enthesitis, dactylitis, ANTERIOR uveitis, plantar fasciitis, achilles tendinitis
Syndesmophytes are what?
Bony spurs from vertebral bodies seen in ank spon
What HLA is ank spon associated with?
Why is ank spon known as the "A disease"?
The Modified New York Criteria for Diagnosis of AS is what?
1. Lower back pain for 3 months - improved with exercise and not relieved by rest
2. Limited lumbar motion - reduced Schobers test (<19cm)
3. Reduced chest expansion
4. Bilateral grade 2-4 sacroilitis on x-ay
5. Bilateral grade 3-4 sacroilitis on x-ray
Definite diagnosis if 4 or 5 plus 1, 2 or 3
What treatment options are given for AS?
Simple analgesia (paracetamol or NSAIDs)
DMARDs for more aggressive disease
Describe the basics of psoriatic arthritis.
Inflammatory asymetric oligoarthritis
Enthesitis (achilles tendinitis, plantar fasciitis)
What nail changes occur in psoriatic arthritis?
Onycholysis (lifting of the nail from it's bed)
Colour change to yellow-brow
Fungal nail infections can occur
Psoriatic arhritis occurs in what % of people affected by skin psoriasis?
What bloods are seen in psoriatic arthritis?
Raised inflam markers
On x-ray what changes are seen in psoriatic arthritis?
"pencil in cup" deformity
What is enthesitis?
Inflammation of the site where tendon or ligament inserts onto the bone.
What treatment can be given for psoriatic arthritis?
Physiotherapy, Ot, Orthotics, Chiropodist
Corticosteroids/ joint injection
DMARDs (MTX, SZP)
Anti-TNF (Etanercept) - most effective agents
What is enterpathic arthritis?
An inflammatory arthritis involving the spine and peripheral joints occuring in pateints with IBD, coeliac disease and pts with extensive bowel resections
What is reactive arthritis?
Arthritis occurs in response to an infection in another part of the body - infection triggers and AI arthropathy
What are the most common infections that initiate reactive arthritis?
Why is history important in rective arthritis?
If food poisioning 2/3 weeks prior then think about reactive arthritis